Hood J R, Campkin N T, Feldman S A
Magill Department of Anaesthetics, Chelsea and Westminster Hospital, London.
Anaesthesia. 1994 Aug;49(8):682-5. doi: 10.1111/j.1365-2044.1994.tb04397.x.
Tubocurare (0.125 mg.kg-1 or 0.25 mg.kg-1) was injected 10 s before 1 mg.kg-1 suxamethonium in patients anaesthetised with enflurane 1-1.5%. Measurement of electromyographic response was recorded using a 0.2 Hz train-of-four every 20 s. The modified blocks were slower in onset, of lesser intensity, and of shorter duration than that of suxamethonium alone, but were much closer to those of suxamethonium than of tubocurare. However, the train-of-four fade observed during onset of the modified blocks were similar to that of their tubocurare controls and significantly different from the suxamethonium group. We conclude that effective amounts of tubocurare are present in the neuromuscular junction within the 30 s following intravenous injection of the drugs, and this affects the onset of action of the suxamethonium block. The presence of train-of-four fade during a predominantly agonist block is difficult to explain on the basis of diminished acetylcholine release and a postsynaptic site of action of suxamethonium.
在接受1 - 1.5%安氟醚麻醉的患者中，在注射1mg·kg⁻¹琥珀胆碱前10秒注射筒箭毒碱（0.125mg·kg⁻¹或0.25mg·kg⁻¹）。每20秒使用0.2Hz四个成串刺激来记录肌电图反应。与单独使用琥珀胆碱相比，复合阻滞起效更慢、强度更小、持续时间更短，但比筒箭毒碱更接近琥珀胆碱。然而，复合阻滞起效期间观察到的四个成串刺激衰减与筒箭毒碱对照相似，且与琥珀胆碱组显著不同。我们得出结论，静脉注射药物后30秒内神经肌肉接头处存在有效量的筒箭毒碱，这影响了琥珀胆碱阻滞的起效。在主要为激动剂阻滞期间出现四个成串刺激衰减，基于乙酰胆碱释放减少和琥珀胆碱的突触后作用位点难以解释。
